For a young male with Stage III intermediate risk NSGCT with active 1 ppd smoking history but normal PFTs and DLCO results, would you still consider use of BEP x 4?

I agree with Dr. @Dr. First Last. However, intermediate risk is between good risk and advanced disease, and in my opinion, despite the NCCN guidelines, I have never seen the logic nor the necessity of treating ALL intermediate patients the same as advanced disease with BEP X 4. Most of my intermedia...

The goal of course, for this patient, should be curative therapy. Being a "young" man makes interpretation of the smoking issue somewhat difficult. If only 18-20 and smoking for 4-5 years, I am not sure this would change my recommendation, if he agrees to discontinue. If 35-40 years of age with a 20...